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How mobile banking and financial incentives can fight TB

Photo Credit: Stop TB Partnership

Earlier this month, the Indus Hospital in Karachi, Pakistan reported a substantial increase in Tuberculosis (TB) detection rates after the start of a program that uses mobile technology and financial incentives to get people to test for the disease.

Since the implementation of the program in January 2011, reported TB cases more than doubled at the hospital. Doctors reported a total of 420 cases in the first quarter of 2011, up from 200 in the last quarter of 2010, before the program was in place.

The program is anchored by a financial incentive scheme and use of mobile technology. In the program, doctors and community health workers who screen for TB are rewarded with a financial incentive through their mobile banking account. Health professionals are rewarded based on both the number of sputum samples that they collect and the number of patients that test positive for active TB following sputum test results.

Mobile banking centers that have emerged in Karachi make this program possible. Health professionals use SMS to send their TB data to the Indus Hospital TB Reach mobile data collection system and in return receive a text message which tells them how many cases they have helped to detect. The incentives are then tabulated and distributed at the mobile banking centers on a monthly basis by the data collection system, called OpenMRS Mobile.

Tackling TB is a big deal in Pakistan and the South Asian region as a whole. According to estimates by the World Health Organization, Pakistan developed nearly 300,000 new cases of TB in 2009, making them 8th on the list of countries most burdened by TB. Case detection is imperative in treating TB because according to TB Reach, for every 10 additional cases detected, an estimated 5 lives are saved and 100 infections are prevented.

The Indus Hospital received a grant from the Stop TB partnership’s TB Reach program. The TB Reach program focuses on promoting increased case detection of TB cases, ensuring their timely treatment, all while maintaining high cure rates within the national TB programs. Working in two “waves,” the first wave targeted 19 countries with $18.4 million worth of funding. The project at the Indus Hospital in Karachi is a product of the first wave. Under its Wave-2 funding, TB Reach has approved US$ 31 million for 45 projects in 29 countries.

The Indus Hospital program’s success has caught local attention as the Indus Hospital health workers are now training local private general practitioners on TB screening and detection. Furthermore Indus Hospital has launched a communications campaign complete with billboards, posters and local cable television ads that encourage people to get tested for TB. The Indus Hospital, also Pakistan’s first hospital to go paperless, hopes to expand the program nationally and even beyond.

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